MEDICARE: MEDICAL PUMPS & SUPPLIES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	30009	TX

General Provider Information

NPI Number	:	1518901149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL PUMPS & SUPPLIES, INC

Provider Business Mailing Address
First Line	:	878 RANCH ROAD 2766
Second Line	:
City	:	JOHNSON CITY
State	:	TX
Zip	:	78636
Country	:	US
Telephone Number	:	830-868-7712
Fax Number	:

Provider Business Practice Location Address
First Line	:	878 RANCH ROAD 2766
Second Line	:
City	:	JOHNSON CITY
State	:	TX
Zip	:	78636
Country	:	US
Telephone Number	:	830-868-7712
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	KATHY GILSTRAP
Credential	:
Telephone Number	:	830-868-7712

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	08/22/2020

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